HomeMy WebLinkAbout002-940-09-3101-LUP-1992-172 Application for Land Use Permit
County of Sawyer � �
The undersi ned hereb makes a lication for a Land Use Permit and � �
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agrees that all work shall be done in compliance with the require- o
ments of the Sawyer County Zoning Ordinance and the laws and regu- Mk
lations of the State of Wisconsin. �. '
PRINT - USE BLACR INK OR PENCIL �W
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�r��;am F. ��.yN� M. oNNSr,� �,e2oy G. Sc.NRo�K �_
Owner Bui_lder � �
RR /n � C3o�. 1v77�- S RR 2, j3oK ��,7� �'
Mailing Address Mailing Address
f{H�lL1/9R.7� WI S'�8'{3 f�Ayin��4Rb� WZ 6�5��'f,3
City, Stat , Zip City, State, Zip
Building Land Use Zone District _ ..R-� o �
( ) New ( ) Filling rt
(X) Addition O Dredging Lot size ��p � �( lv�D � N n
( ) Alteration ( ) Grading
( ) Moving On ( ) Acres /D �401 �
( ) ( ) T— �
A �
New Construction DEcy�- a�f ��ECK - �� -�`
--- Pq r;O �'a r ----- �r o n 7" do a r
Size /2 ft wide � ft wide �
� ft long Q ft long �
Z
Floor area /9�- sq ft �� sq ft �
Total htg J� �'r to �¢ ��T to-gea� �� °� �`A'�'^`6 � o
o�� o�� �rj i�AL�� ��
�����f �
Stories — a�f — Stories ot
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No. of Bedrooms -' rear lot line � --'��- �
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• . ( ���1) �O�O 0� �n rt
G
Type of Bldg or Addition cr r
( ) Dwelling a o
O Garage (1) (2) car D= dw e�� in9 � rt
O storage Building G = garaty e N�
( ) Boathouse ��_ �
( ) Livingroom
( ) 33edroom ¢op� O
( ) Kitchen-Dining � �
( ) Porch - enclosed/roofed �
(X) Deck - ope�z) i
( ) r�
� �- o U�
Type of Construction � 8 � �
�( ) Frame ( ) Block � � ^' 6�' � ��
) Log ( ) Concrete N• £ ,o � �
( ) Po1e ( ) Steel � '' .,<.A � �,
( ) Metal ( ) �S' �6� p� $' w m
,B)e. � �
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Construction Cost $ //O D � I
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Vol �L Pg ��� � ``� of deed �06� �rR
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Cer. Soil Test 9a-�z.s � �
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Sanitary Permit D- /T2 ----------CL Road -001��27)____ o O
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Issued Z� �np �99Z Denied �
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Owner Zoning Admi_nistr tor
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ooeuMEriT No. WpRRANTY DEED � ����s svnr.e ncser�veo Fon nccowoine o�u I'
�� �' �� f STATE BAR OF WISCONSIN FORM 2-1982 il
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I' .. -._ _,_ _ ..__'.._ I _ . __ _ . e(�OIBC� 1 .�{
5��.�.�r �, ��Y � � �C.1
CHARLES McDONNELL ake CHARLES LEE McDONNELL by his „ „ :,� m. e■� .� I
I� attorney-in fact, Charlotte (McDonnel ] ) Hyduke, JOAN �-c�.z �. i: � ��Y_ o� l ���
McDONNELL aka JOAN CATHERINE (McDonnell ) WILLIAMS, by ([A �.+ ��� ���.
her attorney in-fact, Charlotte Theresa _ (McDonnel l ) �, � Y 3�_
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Hyduke, and CHARLOTTE_ McDONNELL aka_ CHARLOTTE �^c�rrc�:��--��-�-�—R�� '
;� (Mc�onnell)._ HYQl1KE aka..CHARLOTTE. iHERESA_(McADNN�1.Ll.__.
' HYDUKE.....a11.._adult....non-residents of_..the.. Sta.te .. of .. . ; � , '
�I Wisconsln, ..conuey and_warrant to .WILLIAM F. JOHNST9N _ .. �
i and LYNN._.M_ . �OHNSION,._.husband..and wife .as _ JOINT _... �
TENANTS_. and not..as..Tenants .in Common,. -non-residents__. AE,,,„„ ro I
of the. Staate of Wisconsin, ___ _ _ _. Ward Wm. Winton, orney �
___.... P.O. Box 796, yward WI 54843
- -y y �
_. .
the following descubed real estate in ...Sdb! 2C . .... .. . _ Count �, .. . . �j�.�v —
State of Wisconsm: � I
Tax Parcel No: _9...4.Q..9..9...�.--.--.-.
The Northeast Quarter of the Southwest Quarter (NE4�SW'l�) , Section Nine (9) ,
Township Forty (40) North, Range Nine (9) West.
This description taken from Hayward Land Title Company Title Insurance Com- -
mitment � 25460.
TRANSFER
� e�
$ _----•
F�r
�i OFF:CIALSE L �.
STACY E. SA80
' � �` a NOTAPY PUBUC CALIfONNIA "
� PRINCIPAL OFFICE IN
�,� LOS ANGELES COUNN
M Commissinn Ex 'res Ma 13 1991
IIThis .......�.5..nOt___._. homestead property.
(is) (is not)
�I r:x����c�o� e� wnrrnnties: QdS81112f1t5, exceptions, restrictions, and reservations of i
record, Sawyer County Zoning Ordinance.
Ch�arlte�s McDonnel� l �ka Ch��s�ee�McD nn l l JoanMMcD nnell aka Joan Cdtherine (Mc onnell
r-$—(n� n q t
BY: C�4�-��� l'V' c.��n,��[�{��4y�� BY�C1a-LI.aL(..� fJQ�.ta�.1!►�� Wi �.�c�
,� , . � , _��
, � r,�.
�I . Charlotte (McDonnell.)_Hyduke, Atty in fa t . Charlotte Theresa (McDonnell ) Hyduke Atty ' in
I �:.-Vu�-ct�-r� ���Qar�u.e�Q� �� � fact �I
S .._.(SE.11.1 II
� • Lharlotte McDonnell .aka Charlotte (McDonneil ) Hyduke _ i�
aka Charlotte Theresa (McDonnell ) Hyduke �
AUTHENTICATION ACKNOWLEDGMENT
� Signature(s) _._...__... _._._............._....._....._ STATE oF CALIFORNIA
� ss.
..--- �----� �---�---�------------�-- �--- - - -- - - � - -� LOS ANGELES �
._____...._..__........___..._County. I_ ' ..._.
� authenticated this __._...-day of....._.__.__.............. 19....._ Personally came before me this _.. l.� day of
i
' � --------Ma�(-----.---._...---� 19..��.. the aLove named �
� � -. . �- �-- -- -� --- �--�� ---- �- - -- - - - - -- - Lharlo.tte..McQonnel l.. aka_CharlQtte..IMcRanne 1 )
� ' _.-_. Hyduke aka.Charlatte.7heresa IMcRonnell ) e',
i - � - - - - -��- - - � - - - - --
� TITLE: EfEMBEA STATE BAR OF WISCONSIN Hyduke,... _ _. f
�� (If not� �---------------------------------------�------ . OR �9YC9.�G./Hl.OA�r_�?A.fU 0 _S!I-P. . G"47K( .
authorized by § 706.06, Wis. Stats.) �tA�� � �- �
te-iuQili�u to Le the person __..._._._ tvho executed the '
� Porc�oin � i� ru mnt and a o I�Jge the same. �
6 6
` _.
THISINSTRUMENT WAS �RAFTED BY
Ward Wm. Winton> Attorney at Law - -
- - -- .... . . - .. . .. . sr��Y E_._sA��_ _.. _
P..II. Bnx Z4fi, hayward, WI_54893 .. ... .. _.. Los Angeles CA I
Notm�y Public _.. _Coouty,
(Signatures may be euthenticuted or ucknowledged. Both h�F ���»�»issfun is}a;rnlae�mt��F not, state expiratior �
ure not necessary.) �Y���' i
dute: .- 19 .. . )
_. -- ---.., . .
V�1� � 4 PC435 i
•N�mea o[ peraons siYnin¢ In �ny cepecity sLuWJ Le typed m� �ain1.J L.�I��w IL,�ir nienolurus. I
WARRANTY OEED S'fA'PE BAA OF WISCONS7N N'i.+r�im:in I,�pW I�Ini�L �'„ ��„
Nnll�t 110. 2-- ItnG
.i�,..�..�1. �V�i.
� DILHR SANITARY PERMIT APPLICATION
_ In accord with ILHR 83.05, Wis. Adm. Code couNn
—.��,...,_.._..w SAWYER " c
CST 90-125 STATESANITARYPERMIT# �
-Attach complete plans(to the county copy only)for the system,on paper not less than 13 80 66 �
8'/x 11 inches in size. ❑ Check If revision to previous application ~
�ee reverse side for instructions for completing this application. srnrE p�nN i.o.NUMSEa
1. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION.
PROPERTV OWNER PpOPEflN LOCATION �
G�(/� DN � YaScu '/a, S T yd, N, R �r) W
PROPERTYOWNER'SMAILINGA DRESS LOT# BLOCK
.� sr
CITY,STATE Z�P CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBEfi
Gv� � aj
II. TYPE OF BUILDING: (Check one ��TY N EST ROAD
� State Owned ❑ VILLAGE OL/�
SJ L/1 7/r a t✓ yJ
❑ Public �1or2Fam. Dwelling—#ofbedrooms� PARCELTAXNUMBER(S)
III. BUILDINGUSE: (Ifbuildingtypeispublic,checkallthatapply) 002-940-09-3101
t ❑ ApVCondo
2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility
3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ RestauranUBar/Dining
4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash
5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify
IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable)
A) 1. � New 2. � Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.❑ Repair of an
System System Tank Only Existing System Existing System
B) ❑ A Sanitary Permit was previously issued. Permit# — Date Issued
V. TYPE OF SYSTEM: (Check only one)
Non-Pressurized Distribution Pressurized Distribution Experimental Other
11 � Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank
12 SeepageTrench 22 ❑ In-Ground 42 ❑ PitPrivy
13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy
14 ❑ System-In-Fill
VI. ABSORPTION SYSTEM INFORMATION:
1.GALLONS PER DAY 2.ABSORP.AAEA 3.ABSORP.AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE
REQUIRED(sq.ft.) PH POSED(sq.ft.) (Gals/day/sq.R.) (Min./inch) ELE�'ATION
// �
Q �� r /� ,� Feet �Od� d Feet
VII. TANK CAPACITY Site
in allons Total #of Prefab. Fiber- Exper.
INFORMATION New istin Gallons Tanks Manufacturer's Name oncrete Con- Steel ylass P�astic APP
Tanks Tanks structed
Se ticTankorHoldin Tank d0
LittPum Tenk/Si honChamber
VIII. RESPONSIBILITY STATEMENT
I,the undersigned,assume responsibiliry for installation of the onsite sewage system shown on the attached plans.
Plumber's Name(Print): Plum s Signature:(No Stgmmps MP/kIPfl9YPTQ6: Business Phone Number:
6�e T r� /r � � 9 1-�.��z
lumber' Address(Sireet,City,Sfete,Zip Code). �
' �L HO J.
IX. COUNTY/DEPARTMENT USE ONLY
❑ Disapproved SaNtary Permit Fee pncludm Grouneweter a e ssue I Agent Signature(No Stamps)
Surcherpe Fee)
Q Approved ❑ Owner Given Initial �115 . �� 8-1-9�
Adverse Determinetlon
X. CONDITIONS OF APPROVALIREASONS FOR DISAPPROVAL:
I
SBD-6398 Qormerly PIbE7)(F. 11/88) DISTRIBUTION: Original to Counry,One CopyTo�.Safery&Buildings Division,Owner,Plumber
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